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Cleft Palate Repair Surgery

Arkansas rates for HCPCS 42200

This surgery repairs a cleft palate, a birth condition in which the roof of the mouth did not fully join together during development, leaving a gap between the mouth and nasal cavity. The surgeon closes the opening in the soft palate, hard palate, or both, restoring a continuous roof of the mouth to support normal speech, feeding, and swallowing. It's typically performed on infants or young children born with this condition.

Facilitymedian $2,291 · 10th–90th $1,122$6,1660%10%10th90th$2,291Professionalmedian $977 · 10th–90th $832$1,5490%20%10th90th$977$500.0$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1,122.02
Median
$1,819.70
Typical High
$2,511.89
Aetna
Setting
Professional
Modifier
Global
Typical Low
$831.76
Median
$977.24
Typical High
$1,548.82
BCBS
Setting
Facility
Modifier
Global
Typical Low
$5,370.32
Median
$5,370.32
Typical High
$7,413.10
BCBS
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$977.24
Typical High
$1,288.25
Cigna
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$794.33
Typical High
$4,365.16
Cigna
Setting
Professional
Modifier
Global
Typical Low
$794.33
Median
$1,202.26
Typical High
$1,778.28
Qualchoice
Setting
Professional
Modifier
Global
Typical Low
$1,548.82
Median
$1,548.82
Typical High
$1,548.82
United
Setting
Facility
Modifier
Global
Typical Low
$1,548.82
Median
$3,981.07
Typical High
$11,481.54
United
Setting
Professional
Modifier
Global
Typical Low
$812.83
Median
$1,071.52
Typical High
$1,698.24